Syllabus · Historical · V4 (2023) · Respiratory System
F12 · Respiratory Measurement
F12.i · Respiratory Measurement
Describe the principles of pulse and tissue oximetry, co-oximetry including calibration, sources of errors and limitations.
Written examination
SAQ history
Oxygen Monitoring — Co-oximetry
1 exam appearance
Outline the principle of co-oximetry (40% of marks), describe what a co-oximeter is able to measure (30% of marks), and compare its limitations to those of a pulse oximeter (30% of marks).
32%
Oxygen Monitoring — Mixed Venous O2
3 exam appearances
Define mixed venous PO2 (20% of marks). Outline the factors that affect this value (80% of marks).
37%
Briefly describe the factors that influence the partial pressure of Oxygen in mixed venous blood.
33%
Oxygen Monitoring — Pulse Oximetry
5 exam appearances
(a) Describe how arterial haemoglobin oxygen saturation is measured using a pulse oximeter including the underlying scientific principles (60% of marks). (b) Outline the limitations and sources of error of this method (40% of marks).
76%
Describe the principles of measurement of arterial haemoglobin O2 saturation using a pulse oximeter (60% marks). Outline the limitations of this technique (40% marks).
74%
Outline the principles underlying pulse oximetry. ( 80% of marks) Briefly describe the effect of an elevated level of the following upon pulse oximetry values. (20% of marks) a. Carboxyhaemoglobin b. Methaemoglobin
34%
Describe the principles of measurement of arterial haemoglobin O2 saturation using a pulse oximeter. (60% of marks) Outline the limitations of this technique. (40% of marks)
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Describe the principles of measurement of arterial haemoglobin oxygen saturation using a pulse oximeter. Outline the limitations of this technique.
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Oxygen Monitoring — ScvO2 vs SvO2
1 exam appearance
Compare and contrast the measurement (40% of marks) and interpretation (60% of marks) of both central venous and mixed venous oxygen saturations.
8%
Oxygen Monitoring — SpO2–SaO2 Discordance
1 exam appearance
Explain why the oxygen-haemoglobin saturation value derived by a pulse oximeter (SpO2) could be different from the measured arterial value (SaO2).
32%
Oral examination
VIVA history
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2021A · Day 2 · VIVA 3
This viva will explore your knowledge of measurement. By what methods can the concentration of oxygen in inspired gas be measured? (Image removed from report.)
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2016B · Day 2 · VIVA 2
This viva discussed humidity, oxygen measurement and concepts around partial pressure.
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2016B · Day 2 · VIVA 8
This viva tested knowledge on pulse oximetry the physiology related to hypoxia and hypoxaemia.
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2016A · Day 2 · VIVA 3
This viva tested knowledge of respiratory physiology and pharmacology. It discussed the functions of the upper respiratory tract, humidity, anatomy of the larynx, principles of pulse oximetry and the pharmacology of some of the drugs used to treat asthma.
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2014A · VIVA 6
This Viva tested knowledge on oxygen. It explored an understanding of the physiological effects of oxygen, measurement of oxygen and principles around humidity.
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2013A · VIVA 2
Explored knowledge of oxygen administration and oxygen measurement (including arterial oxygen saturation and partial pressure). It began by asking candidates to describe the design principles of commonly used oxygen delivery masks.
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2010A · VIVA 2
This viva will test your knowledge of hypoxemia, oxygen therapy and pulse oximetry The following is a blood gas of a young person who has taken a sedative drug overdose. pH 7.2 PO2 40 mmHg PCO2 80 mmHg HCO3- 28 mmols/L Describe this blood gas Apart from being asked to describe the blood gas, candidates were also asked about the Henderson-Hasselbach equation, causes of hypoxaemia, pulmonary shunt, response to supplemental oxygen and pulse oximetry.
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2008B · VIVA 8
The initial information given to the candidates was - This Station will explore aspects of respiratory physiology and related measurement. This Chest Xray shows complete collapse of the Left Lung. What patho-physiological processes might contribute to Hypoxia in this patient? This viva explored the candidates’ knowledge in relation to the following points Describe ventilation and perfusion to the lung and illustrate their relationship Significance of high and low V/Q Shunt and mechanisms to limit hypoxia, effect of supplemental oxygen Pulmonary Vascular Resistance Pulse Oximetry, principles of measurement, limitations (A digital reproduction of a CXR was displayed – but candidates were not expected to make any clinical interpretation of the CXR and were provided with the CXR findings and diagnosis) Examination feedback: Candidates used graphs to illustrate their discussions with good effect. Areas of weakness was in understanding and explaining the limitations of the pulse oximetry. 3 ( 100%) candidates passed this questions A detailed syllabus has been developed and forms the foundation for the knowledge base for the JFIC Primary Examination. All questions are sourced directly from that syllabus and candidates should have a sound understanding of those topics, and confidence to express their understanding of the subject material in both written and oral form. The candidates should be able to integrate and express basic physiological and pharmacological principles as to how the relate to various scenarios relevant to Intensive Care practice. Candidates would find it valuable to develop strategies and standard formats to answer typical questions, eg compare and contrast the pharmacology of Drugs X and Y. Candidates are also strongly encouraged to use accurate and labelled figures and tables wherever possible to help display their knowledge and to describe basic principles. Dr Arthas Flabouris Deputy Chair Primary Examination Committee Circulation: Board of Joint faculty Panel of Examiners Supervisors of Intensive Care Training Course Supervisors Regional Education Offices Registered Trainees
Sources: objective text from the relevant CICM syllabus; historical SAQ and VIVA wording from CICM examiner reports.